Attitudes and perceptions of staff and resident-patients in residential units in Thessaly

Abstract

With the implementation of the psychiatric reform in Greece, the care of chronically mentally ill persons has been transferred into sheltered housing in the community (nursing homes, hostels, sheltered apartments), for the psychosocial rehabilitation of the patients, aiming at the deinstutionalization and their social reintegration. The scope of the present study was to record and analyze the attitudes and perceptions of both staff members and resident-patients of the 17 residential units (5 nursing homes, 4 hostels and 8 sheltered apartments) of "Psychargos" Project in Thessaly, as well as to check the hypothesis of "neo" institutionalization for the units under investigation. Data were collected onsite (field study) from 157 staff members and 88 resident-patients, by structuring and using original questionnaires as well as the Global Assessment Scale (GAS). The independent variables for the staff members (sex, age, education, profession, legal form of the residential unit, previous professional experience in mental health services) as well as for the resident-patients (sex, age, GAS score, legal form of the residential unit, residence time in the unit, and previously in other psychiatric institutions) were correlated to dependent variables in order to assess possible statistical relationships (x2). The statistical significance test p-value was set at 0.05. Data statistical processing was carried out using SPSS 16.0. The hypothesis of "neo"-institutionalization for these residential units was checked in a 34-month follow-up period. Regarding the staff, a positive attitude towards the institution of residential care structures itself was recorded. Nevertheless, a negative opinion regarding the prospect of resident patients recovery, and even skepticism as to the acceptability of these persons by the local community, were expressed. Surely, it is positive that a remarkable percentage of the staff members are willing, even though under certain conditions, to provide foster care to resident-patients. On their part, the resident-patients maintain good relationships with staff and fellow residents, and feel content with their residence itself and the services provided. However, most of them (especially the most functional and with milder symptoms) express their desire for more autonomy, with regard to the degree of supervision received by the staff, their contact with the local community, the perspective of receiving foster care, the perspective of return in their natural family as well as of autonomous living. Ultimately however, the survey results give rise to pessimism with respect to an intermediate-transitional character of the residential units, since only a few resident-patients moved during the follow-up period (34 months) towards reduced-supervision housing and none to the community. However, the functionality of a non-insignificant part of the resident-patients could be employed for leaving "neo"-institutionalized housing and living, and finally their social reintegration.